Figure 2 Brain MRI features of 3 representatives patients with MS who experienced WNS after FTY withdrawal Brain MRI features of 3 representatives patients.

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Figure 2 Brain MRI features of 3 representatives patients with MS who experienced WNS after FTY withdrawal Brain MRI features of 3 representatives patients with MS who experienced WNS after FTY withdrawal (A) Tumefactive demyelination pattern (TDL), Pt.3. (A.a) Axial T2/FLAIR images, showing large and edematous lesions, causing mass effect on adjacent structures; (A.b) Axial TSE-T1 after Gd administration images, showing multiple ring and nodular enhancing lesions; (A.c) axial DWI (on the left) and correspondent ADC maps (on the right) images, showing hyperintense lesions on DWI with correspondent hypointense signal on ADC maps (red arrows), expression of restricted diffusion. (B) Punctuated pattern (PL), Pt.1, SPMS patient. (B.a) axial TSE-T2 images, medium in size (already detectable in previous scans) and new small hyperintense lesions, with no edema and mass effect; (B.b) axial TSE-T1 after gadolinium administration images, showing innumerable millimetric enhancing lesions, both in infratentorial and supratentorial areas. (B.c) axial DWI (on the left) and correspondent ADC maps (on the right) images, showing hyperintense lesions on DWI with correspondent hypointense signal on ADC maps (red arrows), expression of restricted diffusion. (C) Classic MS pattern (CL). (Pt.6) (C.a) Axial FLAIR images, showing medium in size lesions, with no edema and mass effect; (B.b) axial TSE-T1 after gadolinium administration images, showing nodular and ring enhancing lesions. (C.c) Axial DWI (on the left) and correspondent ADC maps (on the right) images, showing hyperintense lesions on DWI with correspondent hyperintense signal on ADC maps (“T2-shine through effect”). Caterina Lapucci et al. Neurol Neuroimmunol Neuroinflamm 2019;6:e566 Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.